Metallic syringe versus electronically assisted injection system: a comparative clinical study in children.

AIM: Local anaesthesia injection necessary for pain control in paediatric dentistry may itself be painful sometimes, partly because of the pressure felt during injection; electronically assisted injection systems were developed to address this problem. MATERIALS AND METHODS: Study design: The present study is a clinical study in children that compared two types of devices for paediatric buccal infiltration anaesthesia: the aspirating syringe and an electronically assisted injection system, the Wand STA. A split mouth, randomised controlled clinical trial was conducted on 30 healthy six to eight-year-old patients (6.64 ± 0.803 years) requiring pulpotomies on two symmetrical primary maxillary molars. Each patient received the following types of anaesthesia, in separate, consecutive, randomly ordered sessions: conventional buccal infiltration by metallic aspirating syringe and buccal infiltration by computer-controlled local anaesthetic device (Single Tooth Anesthesia). Parameters assessed were: pain experienced during injection, patient's heart rate and behaviour, anaesthesia quantity required and onset time. RESULTS: No statistical differences were observed between the two techniques (p? 0.05) for all assessed parameters. CONCLUSIONS: Results suggest that computer-assisted anaesthesia may represent an alternative to conventional syringes for local buccal anaesthesia in paediatric dental treatment; comparison to other types of dental infiltration anaesthesia needs further investigation.

Caries risk management: effect on caries incidence in a sample of Lebanese preschool children.

OBJECTIVES: This clinical prospective study describes how caries preventive measures applied according to caries risk affect new caries incidence in a group of preschoolers, as compared to a group where standardized caries prevention is applied, regardless of risk. METHOD AND MATERIALS: Healthy children, aged four years or less, recruited at the Faculté de Médecine Dentaire, Université Saint-Joseph, Beirut, Lebanon were assigned, after parental consent, to an experimental or a control group. Caries risk was determined based on a parental questionnaire, salivary levels of Steptococcus mutans (Sm) and Lactobacillus (Lb), salivary buffer capacity, plaque levels and carious lesions prevalence, then subjects were classified into four caries risk categories. In the experimental group, preventive measures designed for each risk category were applied periodically, whereas control subjects received only standardized preventive measures at regular intervals. All subjects were reevaluated for Sm, Lb, salivary buffer capacity, plaque and new carious lesions after 24 months. RESULTS: Statistically significant reductions in salivary Sm (p=0.001) and Lb (p=0.003) levels, plaque scores (p=0) and caries incidence (p=0.003) were observed in the experimental group. In the control group, no significant differences were observed between initial and final Sm (p=0.18) and Lb (p=0.109) levels or plaque scores (p=0.255), and caries incidence was not significantly reduced (p=0.584). CONCLUSION: The present study's results suggest that caries preventive measures applied according to caries risk may reduce caries risk factors and new caries incidence in preschool-aged children. These findings deserve further investigation to benefit early childhood caries prevention on a larger scale.

Caries prevalence and caries risk in a sample of Lebanese preschool children.

OBJECTIVES: This study describes early childhood caries prevalence and caries risk in a group of Lebanese preschoolers. METHOD AND MATERIALS: 99 healthy children, aged four years or less, were recruited at the Dental medicine faculty, Saint-Joseph university, Beirut, Lebanon. After parental consent, questionnaires investigated children's dietary and oral hygiene habits and parents' education and health behaviors. Oral examinations, with bite-wing radiographs when necessary, determined decayed-filled surfaces and plaque scores. Salivary testing assessed buffer capacity and streptococcus mutans (Sm) and lactobacillus (Lb) presence. The three tests (questionnaire, oral examination, salivary testing) established a caries risk assessment tool, determining subjects' caries risk scores, classified as low (C0), moderate (C1), high (C2) or very high (C3). RESULTS: 25.3% of subjects were caries-free, 24.2% had 4 carious lesions or less, 28.3%, 5 to 9 lesions and 22.2% over 10 lesions. 11.1% of plaque scores were low to mild, 18.2% moderate, 46.4% high, and 24.3% very high. Salivary buffer capacity was: 29.3% high, 57.6% medium and 13.1% low. High levels of Sm, (66.7%) correlated with plaque presence and proximal caries. High levels of Lb (52.5%) correlated with plaque presence and smooth-surface caries, and correlated significantly with occlusal caries. Regular tooth brushing yielded lower plaque, but not significantly lower caries levels. Systemic fluorides were associated with lower plaque and caries scores. Children of educated parents with regular dental visits and oral hygiene had lower plaque and caries scores. Caries risk distribution was: CO: 16.2%, C1: 29.3%, C2: 15.1% and C3: 39.4%. CONCLUSION: Most subjects had at least one carious lesion (74.7%), and 70.7% showed high to very high plaque scores. Over half the sample presented high or very high caries risk. These findings deserve further investigation of the Lebanese preschoolers' population.